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HomeMy WebLinkAbout1124 Evenstar Ct - Applications/Reroof - 04/02/2012City of 'Fret Coll ins Planning, Development & Transportation 281 N. College Ave P.O. Box 580 Fart Cnlling, CO 80524 Phone 970-416-2740 Fax 224-6134 OVER-THE-COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply). ❑ Air Conditioning ❑ Demolition (interior non-structural) ❑ Electrical Alteration (not service change) ❑ Gas Lighter ❑ Gas Log ❑ Heating Unit ❑ Lawn Sprinkler ❑ Mobile Home replacement Roofing ❑ Sewer Line ❑ Photo -voltaic ❑ Ventilation ❑ Water -Heater ❑ Water Line ❑ Wood/Pellet Stove (must be EPA certified, provide make, model and manufacturer). Complete all applicable information on the application. Incomplete applications will not be accepted. Application #. For otiice use only Date `>'- ,2 -1 a Job Site Address (required) Value of Construction (labor, materials, profit) I .2v / �a 000 Properly Owner Name Address City/State Zip Phone N-� Two nso NSA C4 �a 1 ' a Co s �2a1-oa6 Applicant Name Address City/State Zip Phone Contractor Lic # A-17 g 3 Address City/State Zip Phone todGY Mcv�rA,N Roofeel 4rg I.4-1k (J Fm'cy' c016'v co 9vy";zF o2o2y--laoo Contractor City of FL Collins Sales Tax # Are you paying taxes here or by report? ❑ HereReport Sales Wxnumber 12;IeO2dbyall a»tracft7M Are you paying with your trust account? -P Yes ❑ No 41 3'7 b Is this a residential or commercial project? Iffilesidential _❑ Commercial If residential, is it: ❑ Single Family Detached bf Condo/townhome (single family attached) ❑ Duplex ❑ Multifamily (apartment) ❑ Garage If commercial, is it ❑ Bank ❑ Bar ❑ Church ❑ Hotel/Motel ❑ Medical office ❑ Office ❑ Retail ❑ Restaurant ❑ Other (explain) Is this building 50 years of age or more? ❑ Yes WNo If yes, you may need to contact Historic Preservation If this Is for a demolition permit, what year was the building constructed? Ifpnor to 1975, you coil/ need an asbestos assessment to submit with this application. Description of Aivmbe 2- 9 (- fQvattel *If lawn sprinkler/baddtow preventer, must list licensed plumber. If first-time A/C, must list licensed electrician. Subcontractors: List the company name or City of R' Collins license # -�A) S i�lAMO Electrician PlumberMedtaN'"1 7 cal Roofer QOther I hereby acknowledge that I have read this application and state that the above information is complete and correct. I agree to comply with all requirements contained herein and city ordinances and state laws regulating building construction. I know that a permit is not valid until it has been paid and issued. Applicant: cJ F 2 4. UC S - - r1e Date Print Name: o ignature 04/02/2012 14:45 19702241211 ROCKY MTN ROOFERS PAGE 03/06 Ci f PlaMdn9� °�o11ent & Transpod atian �Y o281 N. College Ave P.O. Box 580 F6rt Collins Ff-gcoilliis, co 5052,1 Plxure 97"16-2740 Fax 22+6134 OVER —'SHE -COUNTER PERMITS ONLY This application is to be used to apply for the following permits only (check all that apply)_ a Air Conditioning A Demolition (interior non-structural) ❑ Electrical Alteration (not service change) © Gas Lighter o Gas Log ❑ Heating Unit © Lawn Sprmlder 13 Mobile Home rapiacement q;,R0 Ping 0 Sewer Line L3 Photo-vohaic ❑ Ventilation ❑ WaterHeater ❑ Water Line O Wood/Petlet Stove (must be EPA certified, provide make, model and manufacturer). Complete all appl information on the Vacation. McompleW appNcatians WUl not be accepted. Application # /I ll?� Date -a ! Forofte use oi* Job SRO Address (wed) - vahre of amstrucbm (tabor, matEnais, profd) 11.2`f / L$ ©oa Property Owner Name , mi '- w" itan Address aty/%ate Zip Phone Rue-lo-APA C1 FOPA 911t;%vnco s .2aE -oas Applicant Name Address Cdy/State zip Phone Gontractor Lic # A- 1119 3 Address {may/Stage Zip Phone to'ck-f m'r-1r*7N Rooft eJ 4rf f. 41�k t^' jrv4r Cvlh'vf ea 9CFX-;L+ o2.oZIf--IA0p Contrndor City of R. Collins Sales -fax # Are you paying taxes here or by repod? ❑ Here N Report 31E S W number&morered by Ifcmdralcfom Are you paying with your trust a000unt? -9 Yes ❑ No �13'7 Is this a residential or cornmerW proiect7 Iff ReWerrWl _El C0>llmelCIal Ir residentia4 is L- EI Single Family Detached At Condoftownhome (single familY attached) ❑ DuPlex Q Muh9fa W (apartrrreitt) E3 Garage V commercial, is ih © Bank t7 Bar Ci church ❑ t awmofei Ci Mewl of%ce (3 office ❑ Retail 17 Restaurant ❑ Other (explain) Is this building 50 yesrs of We or more? 13 Yes MMo If yes. yaa may nmd to caufact ifistmic Premn-agm if this is for a demoUlJon permit, what year was the building oanstruCted7 .Mario' to .075, you whYiwd an asks awaawmittn wbrni' mW #w appJicatfon, Descript]on of D J +uS ll i O L021Ja t3DR W 1 rV u r Al um -be 2 D _C— f 4V akf.f = y8 - *If lame sprinkler/baddlow preventer, mast fist ljc� plumber. If first-ime AIC, mustllist licsised electrician. SubcontactmwL.kt65et»mpwynamewt7YynfRCarm&xrAsLa# ,�,d �tA.rxo >tnn�er Q- I '7 � 3 ptfier is t i hereby aadawwledge drat I have read this appReatmn and state that the abw4e k f wkitlon is complete and correct. I agree ro Compb with all regrriretnents contained herein and M ordnarices aW shft IS" regulating building amd aon. I k ww Vot a permit is not valid until It has bow paid mull Issued. Je